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Do Interictal Spikes Drive Epileptogenesis?

Departments of Pediatrics and Neurology, University of Colorado, School of Medicine, Denver, Staley{at}uchsc.edu

Jennifer L. Hellier

Departments of Pediatrics and Neurology, University of Colorado, School of Medicine, Denver

F. Edward Dudek

Department of Physiology, University of Utah, School of Medicine, Salt Lake City

Interictal spikes are periodic, very brief bursts of neuronal activity that are observed in the electroencephalogram of patients with chronic epilepsy. These spikes are useful diagnostically, but we do not know why they are so strongly associated with the spontaneous seizures that characterize chronic epilepsy. Interictal spikes appear before the first spontaneous seizures in animal models of acquired epilepsy, and spikes are sufficient to induce long-term changes in synaptic connections between neurons. Thus, spikes may guide the development of the neuronal circuits that initiate spontaneous seizures. If so, then attempts to prevent or cure epilepsy may best be directed at spikes rather than seizures.

Key Words: Epilepsy • Interictal spikes • Seizures

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